Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.
Vertebral angiogram; Angiography - head; Carotid angiogram; Cervicocerebral catheter-based angiography; Intra-arterial digital subtraction angiography; IADSA
Cerebral angiography is done in the hospital or radiology center.
An area of your body, usually the groin, is cleaned and numbed with a local numbing medicine (anesthetic). A thin, hollow tube called a catheter is placed through an artery. The catheter is carefully moved up through the main blood vessels in the belly area and chest into an artery in the neck. X-rays help the doctor guide the catheter to the correct position.
Once the catheter is in place, the dye is sent through the catheter. X-ray images are taken to see how the dye moves through the artery and blood vessels of the brain. The dye helps highlight any blockages in blood flow.
Sometimes, a computer removes the bones and tissues on the images being viewed, so that only the blood vessels filled with the dye are seen. This is called digital subtraction angiography (DSA).
After the x-rays are taken, the catheter is withdrawn. Pressure is applied on the leg at the site of insertion for 10 to 15 minutes to stop the bleeding or a device is used to close the tiny hole. A tight bandage is then applied. Your leg should be kept straight for 2 to 6 hours after the procedure. Watch the area for bleeding for at least the next 12 hours. In rare cases, a wrist artery is used instead of the groin artery.
Before the procedure, your provider will examine you and order blood tests.
Tell the provider if you:
You may be told not to eat or drink anything for 4 to 8 hours before the test.
When you arrive at the testing site, you will be given a hospital gown to wear. You must remove all jewelry.
The x-ray table may feel hard and cold. You may ask for a blanket or pillow.
Some people feel a sting when the numbing medicine (anesthetic) is given. You will feel a brief, sharp pain and pressure as the catheter is moved into the body. Once the initial placement is complete, you will not feel the catheter any longer.
The contrast may cause a warm or burning feeling of the skin of the face or head. This is normal and usually goes away within a few seconds.
You may have slight tenderness and bruising at the site of the injection after the test.
Cerebral angiography is most often used to identify or confirm problems with the blood vessels in the brain.
Your provider may order this test if you have symptoms or signs of:
It is sometimes used to:
In some cases, this procedure may be used to get more detailed information after something abnormal has been detected by an MRI or CT scan of the head.
This test may also be done in preparation for medical treatment (interventional radiology procedures) by way of certain blood vessels.
Contrast dye flowing out of the blood vessel may be a sign of bleeding.
Narrowed or blocked arteries may suggest:
Out of place blood vessels may be due to:
Abnormal results may also be due to cancer that started in another part of the body and has spread to the brain (metastatic brain tumor).
Complications may include:
Tell your provider right away if you have:
Adamczyk P, Liebeskind DS. Vascular imaging: computed tomographic angiography, magnetic resonance angiography, and ultrasound. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 40.
Barras CD, Bhattacharya JJ. Current status of imaging of the brain and anatomical features. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 53.
Chernecky CC, Berger BJ. Cerebral angiography (cerebral angiogram) - diagnostic. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:309-310.
Reviewed By: Jason Levy, MD, Northside Radiology Associates, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team